Orbital trocar device with detachable handle and associated methods

ABSTRACT

The present disclosure provides methods for forming or enlarging holes in bone tissue and methods for fixing matched medical plates to bodies. The present disclosure also provides for products produced by the methods of the present disclosure and for apparatuses used to perform the methods of the present disclosure.

PRIORITY

This is a Continuation of International Patent ApplicationPCT/US2017/062631 filed Nov. 20, 2017, which claims priority to U.S.Provisional Patent Application 62/426,027, filed Nov. 23, 2016, thedisclosures of which are incorporated by reference in their entirety.

FIELD OF THE DISCLOSURE

This disclosure is in the field medical treatment devices and methods.In particular, the disclosure relates to devices and methods for use inmedical procedures including devices incorporating cutting tips forcreating or enlarging holes in bone.

BACKGROUND

Orthopedic surgical procedures can require the creation or enlargementof holes in bones. In vertebral surgery, for example, precise alignmentof holes is desirable, and in some instances alignment of holes isnecessary for proper placement of medical devices, such as matchedmedical plates.

Thus, there is a need for medical devices that allow for precisealignment of holes in bone, including alignment of holes for use withother medical devices. The disclosure is directed to these and otherimportant needs.

Disclosure

The present disclosure provides aspects of trocar insertion systemscomprising a driver handle with a driving shaft affixed thereto, a firstmating feature on the end of the driving shaft opposite the driverhandle, an elongated blade fixture having proximal and distal ends witha second mating feature on the distal end, a spring retention featurelocated on the elongated blade fixture between the proximal and distalends, a collar feature located on the elongated blade fixture betweenthe spring retention feature and the distal end, a spring housing capslidably fitted around the elongated blade fixture between the springretention feature and the collar feature, a trocar compression springslidably fitted around the elongated blade fixture between proximal endand the spring retention feature, a spring housing comprising a hollowbody with proximal and distal ends, wherein the distal end is fixedlyattached to the spring housing cap, wherein the trocar compressionspring and spring retention feature are enclosed within the interiorvolume of the spring housing, wherein the trocar compression spring isconfigured to be compressed between the spring retention feature and aspring catching feature located at the proximal end of the springhousing, and wherein at least a portion of the elongated blade fixtureis slidably disposed within the spring housing with the centrallongitudinal axes of the elongated blade fixture and the spring housingbeing coaxially aligned, and wherein the first mating feature and secondmating feature are detachably engaged such that the driving shaft andthe elongated blade fixture are detachably connected in coaxialalignment.

The present disclosure provides kits comprising a driver handle with adriving shaft affixed thereto, wherein the driving shaft comprises afirst mating feature on the end of the driving shaft opposite the driverhandle, and one or more trocar assemblies, wherein each of the one ormore trocar assemblies comprises an elongated blade fixture havingproximal and distal ends with a second mating feature on the distal end,a spring retention feature located on the elongated blade fixturebetween the proximal and distal ends, a collar feature located on theelongated blade fixture between the spring retention feature and thedistal end, a spring housing cap slidably fitted around the elongatedblade fixture between the spring retention feature and the collarfeature, a trocar compression spring slidably fitted around theelongated blade fixture between proximal end and the spring retentionfeature, and a spring housing comprising a hollow body with proximal anddistal ends, wherein the distal end is fixedly attached to the springhousing cap, wherein the trocar compression spring and spring retentionfeature are enclosed within the interior volume of the spring housing,wherein the trocar compression spring is configured to be compressedbetween the spring retention feature and a spring catching featurelocated at the proximal end of the spring housing, wherein at least aportion of the elongated blade fixture is slidably disposed within thespring housing with the central longitudinal axes of the elongated bladefixture and the spring housing being coaxially aligned, and wherein thefirst mating feature and second mating features are configured fordetachable engagement such that the driving shaft and the elongatedblade fixture are detachably connected in coaxial alignment.

The present disclosure provides aspects of devices comprising anelongated blade fixture having proximal and distal ends with a matingfeature on the distal end, a spring retention feature located on theelongated blade fixture between the proximal and distal ends, a collarfeature located on the elongated blade fixture between the springretention feature and the distal end, a spring housing cap slidablyfitted around the elongated blade fixture between the spring retentionfeature and the collar feature, a trocar compression spring slidablyfitted around the elongated blade fixture between proximal end and thespring retention feature, and a spring housing comprising a hollow bodyconfigured to slidably fit around the elongated blade fixture and attachto the spring housing cap.

The present disclosure provides methods of fixing a matched medicalplate having one or more apertures to a body, the methods comprisingpositioning the matched medical plate adjacent to the body such that atleast one of the one or more apertures is oriented towards the body,inserting a first trocar insertion system into a first one of theapertures oriented towards the body, wherein the first trocar insertionsystem comprises a driver handle with a driving shaft affixed thereto, afirst mating feature on the end of the driving shaft opposite the driverhandle, an elongated blade fixture having proximal and distal ends witha second mating feature on the distal end, a spring retention featurelocated on the elongated blade fixture between the proximal and distalends, a collar feature located on the elongated blade fixture betweenthe spring retention feature and the distal end, a spring housing capslidably fitted around the elongated blade fixture between the springretention feature and the collar feature, a trocar compression springslidably fitted around the elongated blade fixture between proximal endand the spring retention feature, a spring housing comprising a hollowbody with proximal and distal ends, wherein the distal end is fixedlyattached to the spring housing cap, wherein the trocar compressionspring and spring retention feature are enclosed within the interiorvolume of the spring housing, wherein the trocar compression spring isconfigured to be compressed between the spring retention feature and aspring catching feature located at the proximal end of the springhousing, wherein at least a portion of the elongated blade fixture isslidably disposed within the spring housing with the centrallongitudinal axes of the elongated blade fixture and the spring housingbeing coaxially aligned, and wherein the first mating feature and secondmating feature are detachably engaged such that the driving shaft andthe elongated blade fixture are detachably connected in coaxialalignment, the methods further comprising engaging the exterior of thefirst trocar insertion system spring housing with the first apertureoriented towards the body, applying a force to the driver handlerelative to the matched medical plate to move the proximal end of theelongated blade fixture through the first aperture oriented towards thebody, fixing the proximal end of the elongated blade fixture to thebody, detaching the driving shaft from the elongated blade fixture bydisengaging the first mating feature and second mating feature, andremoving the driver handle with the driving shaft affixed thereto whileleaving the proximal end of the elongated blade fixture fixed to thebody.

The present disclosure provides methods of forming a pilot hole in bonetissue, the methods comprising positioning a matched medical platehaving one or more apertures adjacent to the bone tissue such that atleast one of the one or more apertures is oriented towards the bonetissue, inserting a first trocar insertion system into a first one ofthe apertures oriented towards the body, wherein the first trocarinsertion system comprises a driver handle with a driving shaft affixedthereto, a first mating feature on the end of the driving shaft oppositethe driver handle, an elongated blade fixture having proximal and distalends with a second mating feature on the distal end, a spring retentionfeature located on the elongated blade fixture between the proximal anddistal ends, a collar feature located on the elongated blade fixturebetween the spring retention feature and the distal end, a springhousing cap slidably fitted around the elongated blade fixture betweenthe spring retention feature and the collar feature, a trocarcompression spring slidably fitted around the elongated blade fixturebetween proximal end and the spring retention feature, a spring housingcomprising a hollow body with proximal and distal ends, wherein thedistal end is fixedly attached to the spring housing cap, wherein thetrocar compression spring and spring retention feature are enclosedwithin the interior volume of the spring housing, wherein the trocarcompression spring is configured to be compressed between the springretention feature and a spring catching feature located at the proximalend of the spring housing, wherein at least a portion of the elongatedblade fixture is slidably disposed within the spring housing with thecentral longitudinal axes of the elongated blade fixture and the springhousing being coaxially aligned, and wherein the first mating featureand second mating feature are detachably engaged such that the drivingshaft and the elongated blade fixture are detachably connected incoaxial alignment, the methods further comprising engaging the exteriorof the trocar insertion system spring housing with the aperture orientedtowards the body, applying a force to the driver handle relative to thematched medical plate to move the proximal end of the elongated bladefixture through the aperture oriented towards the body, forming thepilot hole in the bone tissue with the proximal end of the elongatedblade fixture, and removing the trocar insertion system from the matchedmedical plate aperture.

The present disclosure provides methods of forming a pilot hole in bonetissue, the methods including positioning a matched medical plate havingone or more apertures having first guide of the toroidal interface onone side and a second guide of the toroidal interface on the oppositeside; aligning a trocar insertion system having a drive handle and anelongated blade, with a spring in a movable spring housing having atoroid forming an extended curved annular wall surface at its proximalend with a toroidal covering the blade in an unactuate position;engaging the toroidal interface with the toroid at the first guide ofthe toroidal interface of the aperture oriented towards the body;adjusting the cone of operation of the trocar insertion system viamovement within the cone of operation; applying force to the driverhandle relative to the matched medical plate to move the proximal end ofthe elongated blade fixture and at least a portion of the shaft throughthe toroidal interface and aperture; forming the pilot hole in the bonetissue with the proximal end of the elongated blade fixture within thelimits of a control cone of operation; and, removing the trocarinsertion system from the matched medical plate aperture.

The general description and the following detailed description areexemplary and explanatory only and are not restrictive of thedisclosure, as defined in the appended claims. Other aspects of thepresent disclosure will be apparent to those skilled in the art in viewof the detailed description of the disclosure as provided herein.

DRAWINGS

The summary, as well as the following detailed description, is furtherunderstood when read in conjunction with the appended drawings. For thepurpose of illustrating the disclosure, there are shown in the drawingsexemplary implementations of the disclosure; however, the disclosure isnot limited to the specific methods, compositions, and devicesdisclosed. In addition, the drawings are not necessarily drawn to scale.In the drawings:

FIG. 1 illustrates aspects of a trocar insertion device;

FIG. 2 illustrates aspects of a portion of a trocar insertion device;

FIG. 3 illustrates an assembly view of aspects of a trocar insertiondevice;

FIG. 4 illustrates an assembly view of aspects of a trocar insertiondevice;

FIGS. 5A-5C illustrate an assembly view of aspects of catches andlatches for a trocar device;

FIGS. 6A-D illustrate cut-away views of aspects of a trocar insertiondevices;

FIGS. 7A-8E illustrate aspects of trocar insertion systems;

FIG. 9 illustrates a trocar insertion system kit; and

FIG. 10A-10B illustrate a cut-away view of a portion of a trocarinsertion devices.

FURTHER DISCLOSURE

The present disclosure may be understood more readily by reference tothe following detailed description taken in connection with theaccompanying figures and examples, which form a part of this disclosure.It is to be understood that this disclosure is not limited to thespecific devices, methods, applications, conditions or parametersdescribed and/or shown herein, and that the terminology used herein isfor the purpose of describing particular exemplars by way of exampleonly and is not intended to be limiting of the claimed disclosure. Also,as used in the specification including the appended claims, the singularforms “a,” “an,” and “the” include the plural, and reference to aparticular numerical value includes at least that particular value,unless the context clearly dictates otherwise. The term “plurality”, asused herein, means more than one. When a range of values is expressed,another exemplar includes from the one particular value and/or to theother particular value. Similarly, when values are expressed asapproximations, by use of the antecedent “about,” it will be understoodthat the particular value forms another exemplar. All ranges areinclusive and combinable.

It is to be appreciated that certain features of the disclosure whichare, for clarity, described herein in the context of separate exemplar,may also be provided in combination in a single exemplaryimplementation. Conversely, various features of the disclosure that are,for brevity, described in the context of a single exemplaryimplementation, may also be provided separately or in anysubcombination. Further, reference to values stated in ranges includeeach and every value within that range.

In one aspect, the present disclosure provides trocar insertion systems.As depicted in FIG. 1 , the trocar insertion system may comprise atrocar assembly 100, which can be detachably connected to a handleassembly 200 using mating features provided thereon. Exemplaryimplementations of the handle assemblies 200 and trocar assemblies 100are depicted in FIGS. 3 and 4 . In some exemplars, the trocar insertionsystems may comprise a driver handle (202) with a driving shaft (206)affixed thereto, a first mating feature on the proximal end (220) of thedriving shaft (206) opposite the driver handle (202), an elongated bladefixture (112) having a proximal end (114) and a distal end (102).Between the proximal end (114) and the distal end (102) is an elongatedregion of shaft (115). A spring retention feature (119) located on theelongated blade fixture (112) between the proximal and distal ends(114/102), a collar feature (116) located on the elongated blade fixture(112) between the spring retention feature (119) and the proximal end(114), a spring housing cap (110) slidably fitted around the elongatedblade fixture (112) between the spring retention feature (119) and thecollar feature (116), a trocar compression spring (108) slidably fittedaround the elongated blade fixture (112) between the proximal end (114)and the spring retention feature (119), a spring housing (106)comprising a hollow body with proximal and distal ends 106′/106″,wherein the distal end 106″ is fixedly attached to the spring housingcap (110), the trocar compression spring (108) and spring retentionfeature (119) are enclosed within the interior volume of the springhousing (106), the trocar compression spring (108) is configured to becompressed between the spring retention feature (119) and a springcatching feature (107) located at the proximal end of the spring housing(106), and at least a portion of the elongated blade fixture (112) isslidably disposed within the spring housing (106) with the centrallongitudinal axes of the elongated blade fixture (112) and the springhousing (106) being coaxially aligned. The first mating feature andsecond mating feature can be detachably engaged such that the drivingshaft (206) and the elongated blade fixture (112) are detachablyconnected in coaxial alignment. The spring retention feature (119) maycomprise any feature present on the elongated blade fixture (112) thatis capable of retaining one end of a compression spring in a fixedposition as the spring is compressed against the feature. In someinstances the spring retention feature (119) comprises a retaining ringor clip (120) that is positioned within a slot or groove (118) on theelongated blade fixture (112). In some instances, self-locking retainingrings can be used without a slot or groove on the shaft of the elongatedblade fixture. Driver handle (202) can be a suitable shape to be grippedin a human hand. In some instances, the driver handle can be a welledhandle suitable for medical waste collection during use, as described inU.S. patent application Ser. No. 13/983,535. Driving shaft (206) can beaffixed within driver handle (202) such that rotation of the driverhandle (202) creates rotation of the driver shaft (206) with noslippage. In some instances, the distal end (208) of the driving shaft(206) is affixed within an aperture (204) of driver handle (202).

Spring housing (106) can be formed with any suitable external profile. Acylindrical cross-section is suitable for some applications, while otherpolygonal, star-shaped, keyed, flanged, or grooved cross-sections may bealso suitable in other exemplary implementations. The proximal end (114)of the elongated blade fixture (112) can be located at the center of thecross-section of spring housing (106) or at other positions as desired,provided the proximal end (114) can slide through the end of springhousing (106) during operation.

The trocar assembly (100) and handle assembly (200) can be detachablyconnected using any suitable pair of first and second mating featuresthat allow for connection and disconnection with coaxial alignmentbetween the driving shaft (206) and elongated blade fixture (112). Insome instances, the first mating feature and second mating featurecomprise a pair of helical threads that can detachably engage together.In some instances, the first and second mating features comprise a balldetent mechanism arrangement wherein one of the driving shaft (206) andelongated blade fixture (112) can be received within the other such thata spring-loaded ball falls partially into an aperture in order todetachably connect the driving shaft (206) and elongated blade fixture(112). In some instances, the second mating feature comprises aprotruding part and the first mating feature comprises a depressionadapted to receive the protruding part in a snap joint configuration.Trocar assembly (100) can include an area suitable for grasping by auser, such as the area of the elongated blade fixture (112) betweentrocar locator pin (124) and spring housing cap (110). The grasping areacan be configured for enhanced grip by methods known in the artincluding incorporating coated or textured surfaces, depressions,grooves, or cut-outs that allow for improved grasping and controlledtwisting of the trocar assembly (100) as it is engaged with the handleassembly (200), provided the features do not interfere with the slidableengagement of the spring housing cap (110) and spring housing (106)around the elongated blade fixture (112) as trocar compression spring(108) is compressed.

In some exemplars, trocar assembly (100) and handle assembly (200) canbe detachably connected with spring-loaded configurations. In someexemplars, the driving shaft (206) comprises a hollow tube with a firstaperture (210) and a second aperture (212) through the walls of thehollow tube on opposite sides of the central longitudinal axis of thehollow tube, a third aperture (214) through the wall of the hollow tubein a position between the location of the first and second apertures andthe proximal end of the hollow tube, and a groove (222) through the wallof the hollow tube at the proximal end. In the spring-loadedconfigurations, the trocar insertion systems further comprise a springstop pin (216) fixed within the first and second apertures (210/212) andpassing through the central longitudinal axis of the hollow tube, acontrol pin (218) fixed within the third aperture (214) and partiallyextending into the interior volume of the hollow tube, and a springpressure pin (226) comprising a cylinder configured to slide within theinterior of the hollow tube, positioned within the interior volume ofthe hollow tube with the longitudinal axis of the cylinder aligned withthe hollow tube longitudinal axis. In the spring-loaded configurationsthe spring pressure pin (226) can have a reduced diameter in a portionof the middle of the side walls, the reduction in diameter can be atleast as large as the portion of the control pin that partially extendsinto the interior volume of the hollow tube, and the spring pressure pin(226) can be positioned such that the portion of the control pin thatpartially extends into the interior volume of the hollow tube isslidably contained within the volume of the reduced diameter portion ofthe spring pressure pin (226) between the two non-reduced-diameter endregions of the spring pressure pin (226). In these instances, a handlecompression spring (224) can be positioned within the interior volume ofthe hollow tube between the spring stop pin and the spring pressure pin(226), and a fourth aperture can be located on the elongated bladefixture (112) between the collar feature (116) and the distal end, thedistal end of the elongated blade fixture can be configured to slidablyfit within the interior of the proximal end of the hollow tube, a trocarlocator pin (124) can be fixed within the fourth aperture (122) andpartially extending outward from the elongated blade fixture (112)surface. For connection of the trocar assembly (100) to the handleassembly (200), the driving shaft (206) and elongated blade fixture(112) can be detachably connected by the detachable engagement of thetrocar locator pin (124) within the groove (222) of the driving shaft(206), and the handle compression spring (224) can be at least partiallycompressed by the spring pressure pin (226), which can be slidablycontained between the distal end of the elongated blade fixture (112)and the handle compression spring (224). Aspects of some exemplars ofsuch engagement are depicted in FIGS. 6A-6D.

In some exemplary implementations of the trocar insertion systems theexterior of the spring housing (106) can be configured to engage with anaperture (302) of a matched medical plate (300) such that the springhousing (106) is retained within the aperture (302) and the proximal endof the elongated blade fixture (112) passes through the aperture (302)when a force is applied to the distal end of the elongated blade fixture(112) relative to the matched medical plate (300). FIGS. 7A and 8Adepict one implementation of such a system. FIG. 6A depicts a cut-awayview of an implementation of a trocar insertion system when the trocarcompression spring (108) is compressed by the force against a matchedmedical plate (300), having an aperture 302 which is not shown in FIG.6A, and the proximal end (114) of the elongated blade fixture (112) isexposed. In one aspect, the present disclosure provides a trocarinsertion systems as depicted in FIG. 6D, the trocar insertion systemcomprises a trocar assembly (101), which can be detachably connected toa handle assembly 200 using mating features provided thereon. Theexterior of the spring housing (106) comprises a cylinder with a tapereddiameter proximal end (109) having at its end 109′ a toroid (128)forming an extended curved annular wall surface (129).

FIGS. 7B and 8B depict aspects of implementations of a trocar insertionsystem with toroid end to allow the user to position a blade deploymentin a cone of operation. FIGS. 7B and 6D depicts a view of animplementation of a trocar insertion system when the trocar compressionspring is in an un-actuated state whereby the spring housing covers theelongated blade. When actuated via compression by the force against amatched medical plate (350), as is shown in FIG. 8B, and the proximalend (114) of the elongated blade fixture is exposed.

FIG. 8B further illustrates aspects of a trocar with spring housing withmatched medical plate 350 and toridal interface 400. A matched medicalplate refers to a medical plate that matches the distal end of thespring housing (106) with tapered diameter proximal end (109). In thisexemplar the toroid (128) portion at the end (109′) forms an extendedcurved annular wall surface (129). The annular wall surface matesreversible with the curved guide (401) which provides for movement ofthe device and the exposed proximal end (114) which protrudes throughthe matched medical plate (350) thereby allowing for operation,resection and tool usage at angles other than perpendicular to thematched medical plate. Those of ordinary skill in the art will recognizethat the toroid (128) may be positioned at a non-tapered distal end ifthe spring housing does not include a tapered end and such anarrangement is within the scope of this disclosure.

FIGS. 8C-8E illustrates aspects of a trocar with spring housing withmatched medical plate 355 and toridal interface 400. In this exemplarthe toroid (128) portion again covers the end (109′) forming an extendedcurved annular wall surface (129) and it mates reversible with the firstguide (402) of the toroidal interface (400) which provides for movementof the device and the exposed proximal end (114) in the first guide(402) which is placed away from a body being operated on. Duringoperation the elongated shaft (115) of an exposed proximal end (114) ofthe elongated blade fixture (112) is limited to movement within thesecond guide (404). Which faces the body being operated on, of thetoroidal interface. The maximum area of operation for the exposedproximal end (114) is set by a control cone of operation (406) in thetoroidal interface which is defined by the angle theta “θ” of the secondguide (404). FIG. 8C illustrates operation when the position of theshaft (115) is at theta “θ” of about 10 degrees. FIG. 8D illustratesoperation when the position of the shaft (115) is at theta “θ” of about20 degrees. FIG. 8E illustrates operation when the position of the shaft(115) is at theta “θ” of about 30 degrees.

In some exemplary implementations of the trocar insertion systems theexterior of the spring housing (106) comprises a cylinder with a tapereddiameter proximal end (109) near the proximal end of the elongated bladefixture (112). One such exemplar is depicted in FIG. 10 .

The proximal end of the elongated blade fixture can be any shape desiredby a user. Suitable shapes can include drivers, screwdrivers, wrenches,cutters, probes, retractors, resectors, awls, prods, or other shapesuseful for surgical applications. In some instances of the trocarinsertion systems the proximal end of the elongated blade fixture (112)comprises a shape suitable for anchoring into body tissue. In someinstances the trocar insertion systems the proximal end of the elongatedblade fixture (112) comprises a bone awl. In some instances the trocarinsertion systems the proximal end of the elongated blade fixture (112)comprises a shape suitable for forming pilot holes in bone. In someinstances the trocar insertion systems the elongated blade fixture (112)further comprises a lumen. In some instances a portion of the elongatedblade fixture shaft comprises a cutting or filing zone.

FIGS. 5A-5C depict groove (222) of the driving shaft (206) that isincluded in some instances of the trocar insertion systems. Duringdetachable engagement, trocar locator pin (124) slides into groove (222)and is held in place in a resting position (223) of the groove by theforce exerted by the handle compression spring (224) when the spring isin a compressed state, as depicted in FIGS. 6A and 6B. Groove (222) canbe formed in a variety of shapes, provided that the groove (222) allowsfor insertion of trocar locator pin (124) and provides a restingposition (223). In some exemplars, the force applied to the elongatedblade fixture (112) during methods of use will compress the handlecompression spring (224) such that the trocar locator pin (124) isdriven into a working position (225). Working position (225) can beprovided in various positions of the groove (222) and preferably allowsfor the elongated blade fixture (112) to be rotated with the rotation ofthe driver handle (202) and driving shaft (206). In some exemplars, theforce applied to the elongated blade fixture (112) during methods of usewill not compress the handle compression spring (224), and the elongatedblade fixture (112) can be rotated with the rotation of the driverhandle (202) and driving shaft (206) with trocar locator pin (124)remaining in the resting position (223).

The present disclosure also provides kits comprising one or more trocarassemblies (100) and one or more handle assemblies (200). In someexemplary implementations the kits comprise a driver handle (202) with adriving shaft (206) affixed thereto, wherein the driving shaft (206)comprises a first mating feature on the end of the driving shaft (206)opposite the driver handle (202) and one or more trocar assemblies(100). In some instances the one or more trocar assemblies 100 comprisean elongated blade fixture (112) having proximal and distal ends with asecond mating feature on the distal end, a spring retention feature(119) located on the elongated blade fixture (112) between the proximaland distal ends, a collar feature (116) located on the elongated bladefixture (112) between the spring retention feature (119) and the distalend, a spring housing cap (110) slidably fitted around the elongatedblade fixture (112) between the spring retention feature (119) and thecollar feature (116), a trocar compression spring (108) slidably fittedaround the elongated blade fixture (112) between proximal end and thespring retention feature (119), a spring housing (106) comprising ahollow body with proximal and distal ends, wherein the distal end isfixedly attached to the spring housing cap (110), wherein the trocarcompression spring (108) and spring retention feature (119) are enclosedwithin the interior volume of the spring housing (106), wherein thetrocar compression spring (108) is configured to be compressed betweenthe spring retention feature (119) and a spring catching feature (107)located at the proximal end of the spring housing (106), and wherein atleast a portion of the elongated blade fixture (112) is slidablydisposed within the spring housing (106) with the central longitudinalaxes of the elongated blade fixture (112) and the spring housing (106)being coaxially aligned, and wherein the first mating feature and secondmating features are configured for detachable engagement such that thedriving shaft (206) and the elongated blade fixture (112) are detachablyconnected in coaxial alignment. In some instances, kits can furthercomprise a tool configured for connecting a trocar assembly to thedriving shaft (206), detaching a trocar assembly from the driving shaft(206), or both. One exemplar of a kit is depicted in FIG. 9 , which caninclude one or more trocar assemblies 100/101, one or more handleassemblies 200, one or more fixed drivers 400, one or moretorque-limiting drivers 500, one or more matched medical plates300/350/355, and one or more plate holding forceps 600 contained in asterile-packed instrument tray 700. In some exemplary implementations,as many of the components in the kits are designed for single-use andare disposable. In some instances, the entire kit is compatible withmedical-grade sterilization procedures, including but not limited toethylene oxide (EtO) and gamma ray sterilization.

The present disclosure also provides devices comprising an elongatedblade fixture (112) having proximal and distal ends with a matingfeature on the distal end, a spring retention feature (119) located onthe elongated blade fixture (112) between the proximal and distal ends,a collar feature (116) located on the elongated blade fixture (112)between the spring retention feature (119) and the distal end, a springhousing cap (110) slidably fitted around the elongated blade fixture(112) between the spring retention feature (119) and the collar feature(116), a trocar compression spring (108) slidably fitted around theelongated blade fixture (112) between proximal end and the springretention feature (119), and a spring housing (106) comprising a hollowbody configured to slidably fit around the elongated blade fixture (112)and attach to the spring housing cap (110). In some instances, thedevices may comprise a spring housing (106) that further comprisesproximal and distal ends, wherein the distal end is attached to thespring housing cap (110), the trocar compression spring (108) and springretention feature (119) are enclosed within the interior volume of thespring housing (106), the trocar compression spring (108) is configuredto be compressed between the spring retention feature (119) and a springcatching feature (107) located at the proximal end of the spring housing(106), and at least a portion of the elongated blade fixture (112) isslidably disposed within the spring housing (106) with the centrallongitudinal axes of the elongated blade fixture (112) and the springhousing (106) being coaxially aligned. In some instances the exterior ofthe spring housing (106) can be configured to engage with an aperture(302) of a matched medical plate (300) or the toroidal interface (400)in matched medical plates (350/355) such that the spring housing (106)is retained within the aperture (302) and the proximal end of theelongated blade fixture (112) passes through the aperture (302) when aforce is applied to the distal end of the elongated blade fixture (112)relative to the matched medical plate (350/355). In some instances ofthe devices the exterior of the spring housing (106) comprises acylinder with a tapered diameter at its proximal end (109). The proximalend of the elongated blade fixture can be any shape desired by a user.Suitable shapes can include drivers, screwdrivers, wrenches, cutters,probes, retractors, resectors, awls, prods, or other shapes useful forsurgical applications. In some instances of the devices the proximal endof the elongated blade fixture (112) comprises a shape suitable foranchoring into body tissue. In some instances of the trocar insertionsystems the proximal end of the elongated blade fixture (112) comprisesa bone awl. In some instances of the devices the proximal end of theelongated blade fixture (112) comprises a shape suitable for formingpilot holes in bone. In some instances of the devices the elongatedblade fixture (112) further comprises a lumen. In some instances of thedevices a portion of the elongated blade fixture shaft comprises acutting or filing zone.

The present disclosure provides methods of using one or more trocarassemblies (100) and one or more handle assemblies (200) disclosedherein. In some aspects, the methods of use include methods of fixingmatched medical plates (300/350/355) to a body. In other aspects, themethods of use include methods of forming pilot holes in bone tissue. Insome exemplary implementations the methods of forming pilot holes inbone tissue can include the use of matched medical plates (300/350/355),and can be used to form pilot holes aligned with apertures (302) of thematched medical plates (300/350/355).

The present disclosure provides methods of fixing a matched medicalplate (300) having one or more apertures (302) to a body, the methodscomprising positioning the matched medical plate (300/3510/355) adjacentto the body such that at least one of the one or more apertures (302) isoriented towards the body, inserting a first trocar insertion systeminto a first one of the apertures (302) oriented towards the body,wherein the first trocar insertion system comprises (i) a driver handle(202) with a driving shaft (206) affixed thereto, (ii) a first matingfeature on the end of the driving shaft (206) opposite the driver handle(202), (iii) an elongated blade fixture (112) having proximal and distalends with a second mating feature on the distal end, (iv) a springretention feature (119) located on the elongated blade fixture (112)between the proximal and distal ends, (v) a collar feature (116) locatedon the elongated blade fixture (112) between the spring retentionfeature (119) and the distal end, (vi) a spring housing cap (110)slidably fitted around the elongated blade fixture (112) between thespring retention feature (119) and the collar feature (116), (vi) atrocar compression spring (108) slidably fitted around the elongatedblade fixture (112) between proximal end and the spring retentionfeature (119), and (vii) a spring housing (106) comprising a hollow bodywith proximal and distal ends, wherein the distal end is fixedlyattached to the spring housing cap (110), wherein the trocar compressionspring (108) and spring retention feature (119) are enclosed within theinterior volume of the spring housing (106), wherein the trocarcompression spring (108) is configured to be compressed between thespring retention feature (119) and a spring catching feature (107)located at the proximal end of the spring housing (106), wherein atleast a portion of the elongated blade fixture (112) is slidablydisposed within the spring housing (106) with the central longitudinalaxes of the elongated blade fixture (112) and the spring housing (106)being coaxially aligned, and wherein the first mating feature and secondmating feature are detachably engaged such that the driving shaft (206)and the elongated blade fixture (112) are detachably connected incoaxial alignment, the method further comprising engaging the exteriorof the first trocar insertion system spring housing (106) with the firstaperture (302) oriented towards the body, applying a force to the driverhandle (202) relative to the matched medical plate (300/350/355) to movethe proximal end of the elongated blade fixture (112) through the firstaperture (302) oriented towards the body, fixing the proximal end of theelongated blade fixture (112) to the body, detaching the driving shaft(206) from the elongated blade fixture (112) by disengaging the firstmating feature and second mating feature, and removing the driver handle(202) with the driving shaft (206) affixed thereto while leaving theproximal end of the elongated blade fixture (112) fixed to the body. Insome exemplary implementations, the methods further comprise positioningthe matched medical plate (300) adjacent to the body such that a secondaperture of the one or more apertures (302) is oriented towards thebody, and the methods further comprise engaging the first mating featureon the end of the driving shaft (206) with a third mating feature of atrocar device to form a second trocar insertion system, wherein thetrocar device comprises (i) an elongated blade fixture (112) havingproximal and distal ends with a third mating feature on the distal end,(ii) a spring retention feature (119) located on the elongated bladefixture (112) between the proximal and distal ends, (iii) a collarfeature (116) located on the elongated blade fixture (112) between thespring retention feature (119) and the distal end, (iv) a spring housingcap (110) slidably fitted around the elongated blade fixture (112)between the spring retention feature (119) and the collar feature (116),(v) a trocar compression spring (108) slidably fitted around theelongated blade fixture (112) between proximal end and the springretention feature (119), and (vi) a spring housing (106) comprising ahollow body configured to slidably fit around the elongated bladefixture (112) and attach to the spring housing cap (110), the methodsfurther comprising inserting the second trocar insertion system into thesecond aperture oriented towards the body, engaging the exterior of thespring housing (106) of the second trocar insertion system with theaperture, applying a force to the driver handle (202) relative to thematched medical plate (300) to move the proximal end of the elongatedblade fixture (112) of the second trocar insertion system through theaperture, fixing the proximal end of the elongated blade fixture (112)of the second trocar insertion system to the body, detaching the drivingshaft (206) from the trocar device by disengaging the first matingfeature and the third mating feature, and removing the driver handle(202) with the driving shaft (206) affixed thereto while leaving theproximal end of the elongated blade fixture (112) of the trocar devicefixed to the body.

The present disclosure provides methods of forming a pilot hole in bonetissue, the methods comprising positioning a matched medical plate (300)having one or more apertures (302) adjacent to the bone tissue such thatat least one of the one or more apertures (302) is oriented towards thebone tissue, inserting a trocar insertion system into one of theapertures (302) oriented towards the body, wherein the trocar insertionsystem comprises (i) a driver handle (202) with a driving shaft (206)affixed thereto, (ii) a first mating feature on the end of the drivingshaft (206) opposite the driver handle (202), (iii) an elongated bladefixture (112) having proximal and distal ends with a second matingfeature on the distal end, (iv) a spring retention feature (119) locatedon the elongated blade fixture (112) between the proximal and distalends, (v) a collar feature (116) located on the elongated blade fixture(112) between the spring retention feature (119) and the distal end,(vi) a spring housing cap (110) slidably fitted around the elongatedblade fixture (112) between the spring retention feature (119) and thecollar feature (116), (vii) a trocar compression spring (108) slidablyfitted around the elongated blade fixture (112) between proximal end andthe spring retention feature (119), and (viii) a spring housing (106)comprising a hollow body with proximal and distal ends, wherein thedistal end is fixedly attached to the spring housing cap (110), whereinthe trocar compression spring (108) and spring retention feature (119)are enclosed within the interior volume of the spring housing (106),wherein the trocar compression spring (108) is configured to becompressed between the spring retention feature (119) and a springcatching feature (107) located at the proximal end of the spring housing(106), wherein at least a portion of the elongated blade fixture (112)is slidably disposed within the spring housing (106) with the centrallongitudinal axes of the elongated blade fixture (112) and the springhousing (106) being coaxially aligned, and wherein the first matingfeature and second mating feature are detachably engaged such that thedriving shaft (206) and the elongated blade fixture (112) are detachablyconnected in coaxial alignment, the methods further comprising engagingthe exterior of the trocar insertion system spring housing (106) withthe aperture (302) oriented towards the body, applying a force to thedriver handle (202) relative to the matched medical plate (300/350/355)to move the proximal end of the elongated blade fixture (112) throughthe aperture (302) oriented towards the body, forming the pilot hole inthe bone tissue with the proximal end of the elongated blade fixture(112), and removing the trocar insertion system from the matched medicalplate (300) aperture (302).

In any of the above exemplary implementations when utilizing a matchedmedical plate (350/355) with a toroidal interface (400) the elongatedblade fixture (112) can be utilized along any portion of the controlcone of operation (406). Accordingly, the angle theta “θ” which definesthe maximum cone of operation may be preset. In some instance the kitmay contain several matched medical plate (which may be marked to showtheir aspects of cones of operation) and some may be preset at theta “θ”less or greater than others thereby providing the user a choice on whoto limit the cone of operation.

Those of ordinary skill in the art will appreciate that a variety ofmaterials can be used in the manufacturing of the components in thedevices and systems disclosed herein. Any suitable structure and/ormaterial can be used for the various features described herein, and askilled artisan will be able to select an appropriate structures andmaterials based on various considerations, including the intended use ofthe systems disclosed herein, the intended arena within which they willbe used, the sterilization parameters and/or sterilants to which theyare intended to be exposed, and the equipment and/or accessories withwhich they are intended to be used, among other considerations.Conventional polymeric, metal-polymer composites, ceramics, and metalmaterials are suitable for use in the various components. Examples ofsuitable polymer materials include polyetherimide (Ultem®),polyacrylamide (Ixef®), and other medical grade engineered polymeric(plastic) materials, extruded, injection-molded, or otherwise formedinto the desired structures. In some instances, the number of polymercomponents is maximized in order to provide systems most suitable assingle-use disposables. For uses requiring stronger systems, particularcomponents such as the elongated blade fixture (112) and driving shaft(206) can be machined or ground stainless steel, including 302, 316,416, 420, 440c, 455, 465, 17-4, 17-7, and other grades. In someinstances the spring housing (106), trocar locator pin (124), springstop pin (216), control pin (218), and spring pressure pin (226) can bemade from stainless steel, including 302, 316, 416, 420, 440c, 455, 465,17-4, 17-7, and other grades. Trocar compression spring (108) and handlecompression spring (224) can be stainless steel or medical gradeengineered polymer, provided they are selected to provide suitablespring rates and cycle life for the desired use. Matched medical plates(300/350/355) can be radiopaque in some instances. Materials hereinafterdiscovered and/or developed that are determined to be suitable for usein the features and elements described herein would also be consideredacceptable.

When ranges are used herein for physical properties, such as molecularweight, or chemical properties, such as chemical formulae, allcombinations, and subcombinations of ranges for specific exemplartherein are intended to be included.

The disclosures of each patent, patent application, and publicationcited or described in this document are hereby incorporated herein byreference, in its entirety.

Those of ordinary skill in the art will appreciate that numerous changesand modifications can be made to the exemplars of the disclosure andthat such changes and modifications can be made without departing fromthe spirit of the disclosure. It is, therefore, intended that theappended claims cover all such equivalent variations as fall within thetrue spirit and scope of the disclosure.

What is claimed:
 1. A detachable trocar assembly comprising: a hollowbody with a proximal end and a distal end, wherein the distal end isfixedly attached to a spring housing cap, wherein the proximal endcomprises a tapered diameter terminating in an extended curved annularwall surface, said extended curved annular wall surface comprising asubstantially linear surface at said proximal end; a trocar compressionspring and spring retention feature are enclosed within an interiorvolume of the hollow body, wherein the trocar compression spring isconfigured to be compressed between the spring retention feature and aspring catching feature located at the proximal end of the hollow body;at least a portion of an elongated blade fixture having a proximal endand a distal end, wherein said portion is slidably disposed within thehollow body with central longitudinal axes of the elongated bladefixture and the hollow body being coaxially aligned; a trocar locatorpin extending from a portion of the elongated blade fixture; a partiallyhollow drive shaft having a stop pin fixed inside the shaft and acontrol pin extending partially within a shaft aperture; a groove formedat the proximal end of the partially hollow drive shaft configured totemporarily retain the trocar locator pin; a spring fitted within thedrive shaft and against the stop pin; and a spring pressure pin withinthe partially hollow drive shaft placed between the spring and elongatedblade fixture configured to limit movement via the control pin.
 2. Thedetachable trocar assembly of claim 1 further comprising: a driverhandle with an at least partially hollow driving shaft affixed thereto;and a first mating feature on an open proximal end of the driving shaftopposite the driver handle.
 3. The detachable trocar assembly of claim 2further comprising: the elongated blade fixture has a second matingfeature on its distal end; and the spring retention feature is locatedon the elongated blade fixture between the proximal and distal ends. 4.The detachable trocar assembly of claim 3 further comprising: a collarfeature located on the elongated blade fixture between the springretention feature and the distal end; and the spring housing capslidably fitted around the elongated blade fixture between the springretention feature and the collar feature.
 5. The detachable trocarassembly of claim 3 further comprising the trocar compression springslidably fitted around the elongated blade fixture between the proximalend and the spring retention feature.
 6. The detachable trocar assemblyof claim 1 further comprising a toroid at the proximal end of the hollowbody forming said extended curved annular wall surface.
 7. A method offorming a pilot hole in bone tissue, the method comprising: positioninga matched medical plate having one or more apertures with curved guidesadjacent to the bone tissue such that at least one of the one or moreapertures is oriented towards the bone tissue; movably fixing a springhousing within an open proximal end of a driving shaft attached to adriver handle; the spring housing comprising a hollow body with aproximal end and a distal end, wherein the proximal end comprises atapered diameter terminating in an extended curved annular wall surface,said extended curved annular wall surface comprising a substantiallylinear surface at said proximal end, wherein the distal end is fixedlyattached to a spring housing cap, a trocar compression spring and springretention feature are enclosed within an interior volume of the springhousing, the trocar compression spring is configured to be compressedbetween the spring retention feature and a spring catching featurelocated at a proximal end of the spring housing, at least a portion ofan elongated blade fixture is slidably disposed within the springhousing with central longitudinal axes of the elongated blade fixtureand the spring housing being coaxially aligned; wherein a first matingfeature and a second mating feature are detachably engaged such that thedriving shaft and the elongated blade fixture are detachably connectedin coaxial alignment and retained via a control pin of the elongatedblade fixture temporarily held within a groove of the driving shaft;inserting a trocar insertion system into one of the apertures orientedtowards the body; engaging the proximal end of the spring housing withthe aperture oriented towards the body; applying a force to the driverhandle relative to the matched medical plate to move the proximal end ofthe elongated blade fixture through the aperture oriented towards thebody; forming the pilot hole in the bone tissue with the proximal end ofthe elongated blade fixture; and removing the trocar insertion systemfrom the matched medical plate aperture.
 8. The method of forming apilot hole of claim 7 wherein the elongated blade fixture has a distalend with a second mating feature on its distal end; and the springretention feature is located on the elongated blade fixture between theproximal and distal ends.
 9. The method of forming a pilot hole of claim8 wherein a collar feature is located on the elongated blade fixturebetween the spring retention feature and the distal end; and the springhousing cap is slidably fitted around the elongated blade fixturebetween the spring retention feature and the collar feature.
 10. Themethod of forming a pilot hole of claim 9 wherein the trocar compressionspring is slidably fitted around the elongated blade fixture between theproximal end and the spring retention feature.